A radiation oncologist\u27s story: high tech meets high touch

Personal reflection on the interplay between radiation oncology, which has long been on the leading edge of technological advances in treatment planning and delivery systems, and the personal side of medicine, often known as high touch

Principles of Multidisciplinary Management

This chapter in Cancer Concepts: a Guidebook for the Non-Oncologist describes the principles of multi-disciplinary management, meaning multi-specialty physician management of malignancies. Tumor Boards are the model for multi-disciplinary management. They may be site specific or include the entire spectrum of malignancy. At Tumor Boards, staging workup and treatment recommendations are made collectively, and then the treatments are delivered by the respective modality specialists and their individual teams. Improved clinical decision making leading to superior survival for patients with some diseases and better quality of life has been documented with multi-disciplinary management. Just like curative patients, palliative patients require multi-disciplinary management.https://escholarship.umassmed.edu/cancer_concepts/1006/thumbnail.jp

Treatment of Cancer Pain

Pain is one of the first concerns most cancer patients express when newly diagnosed or meeting a new physician. They are concerned about how much pain they presently have, how much pain they are likely to experience, and their physicians’ commitment to treating cancer pain. The reality is that many cancer patients will never experience pain during their course and for those that do, the great majority can be well-managed with the tools described in this chapter in Cancer Concepts: A Guidebook for the Non-Oncologist. It is incumbent on every physician to understand the mechanisms of cancer pain and the fundamentals of treating it.https://escholarship.umassmed.edu/cancer_concepts/1024/thumbnail.jp

Cancer as a Chronic Disease

Cancers which were once fatal are increasingly able to be managed as chronic diseases. While most metastatic cancers in adults may not be curable, they often can be controlled for long periods of time with a succession of treatments. In this chapter in Cancer Concepts: A Guidebook for the Non-Oncologist, we will examine those cancers with longer natural histories and those with extended survivals due to therapeutic advances. Finally, several cases will be presented that exemplify this new paradigm of cancer as a chronic disease.https://escholarship.umassmed.edu/cancer_concepts/1028/thumbnail.jp

Introduction to Cancer Concepts: A Guidebook for the Non-Oncologist

This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist presents an introduction to the Guidebook, which developed from the Cancer Concepts course at the University of Massachusetts Medical School.https://escholarship.umassmed.edu/cancer_concepts/1011/thumbnail.jp

Environmental and Infectious Causes of Malignancy

This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist presents a summary of the most relevant causative agents of cancer. Exposure to many environmental agents is associated with an increased incidence of certain malignancies, although causation is usually difficult to prove. Certain chemicals, infections (parasitic, viral, and bacterial) and ionizing radiation are known carcinogens. Variable genetic susceptibility to carcinogenesis is apparent. Up to 2/3 of human cancers are believed to have an environmental component.https://escholarship.umassmed.edu/cancer_concepts/1007/thumbnail.jp

Oncologic Emergencies and Urgencies

This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist presents a discussion of the risks to cancer patients for oncologic and metabolic crises. These effects may be caused by the cancer, the treatment provided to cure or palliate the cancer, and/or other medical conditions. They may occur at initial presentation, as a first sign of disease or during the disease course. Oncologists divide these crises into emergencies and urgencies, depending on the severity of the consequences of delay in treatment. Every health care provider should be aware of the signs and symptoms of oncologic urgencies and emergencies and initial management.https://escholarship.umassmed.edu/cancer_concepts/1010/thumbnail.jp

Supporting Cancer Knowledge Needs Using Online Information

Information is exploding at an exponential rate. Because there is a flood of medical information on the Internet, it can be difficult to wade through the many resources to determine what information is best to use in practice. The intent of this chapter in Cancer Concepts: A Guidebook for the Non-Oncologist is to help the health care provider find reliable online cancer information. To help inform clinical decision making, health science librarians continue to address this rapidly growing body of literature by analyzing resources and identifying the highest quality information available on the Internet. The concept of Evidence-Based Medicine (EBM) is important to understand, as well as the process needed to find literature supporting EBM. Why EBM? EBM is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. Making evidence-based clinical decisions is not about intuition, but finding reliable, up-to-date literature and using it in combination with clinical expertise and patient choice. Once a source for free online quality literature is located, a health care provider can consider the best current evidence to thoroughly answer clinical questions.https://escholarship.umassmed.edu/cancer_concepts/1026/thumbnail.jp

Staging of Cancer

The “stage” of a cancer is a short-hand way of describing the extent of cancer in a patient. Stage is based on macroscopic involvement of tissues by cancer. Staging of cancer occurs prior to the beginning of treatment, or at the first definitive surgery. Clinical staging, which includes radiography and exam findings, takes place initially. Pathologic staging, which is obtained from surgical specimens, can be acquired during the course of surgical treatment. Patients then carry either the clinical stage or the pathologic stage for the duration of their illness. This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist will describe principles of cancer staging.https://escholarship.umassmed.edu/cancer_concepts/1003/thumbnail.jp

Cancers of Unknown Primary

Cancers of unknown primary (CUP) are a heterogeneous group of histologically proven metastatic tumors whose primary site can\u27t be determined after a standard diagnostic and pathologic work-up. This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist presents provides an overview of cancers of unknown primary, including initial evaluation and principles of treatment.https://escholarship.umassmed.edu/cancer_concepts/1016/thumbnail.jp